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56.826, \"end\": 57.026, \"score\": 0.897}, {\"word\": \"來\"}, {\"word\": \"事\", \"start\": 57.026, \"end\": 57.207, \"score\": 0.882}, {\"word\": \"實\"}, {\"word\": \"上\", \"start\": 57.207, \"end\": 57.407, \"score\": 0.973}, {\"word\": \"是\", \"start\": 57.407, \"end\": 57.847, \"score\": 0.941}, {\"word\": \"大\", \"start\": 57.847, \"end\": 58.027, \"score\": 0.809}, {\"word\": \"家\", \"start\": 58.027, \"end\": 58.187, \"score\": 0.856}, {\"word\": \"滿\"}, {\"word\": \"意\", \"start\": 58.187, \"end\": 58.328, \"score\": 0.904}, {\"word\": \"度\", \"start\": 58.328, \"end\": 58.468, \"score\": 0.984}, {\"word\": \"也\", \"start\": 58.468, \"end\": 58.608, \"score\": 0.987}, {\"word\": \"非\", \"start\": 58.608, \"end\": 58.648, \"score\": 0.496}, {\"word\": \"常\", \"start\": 58.648, \"end\": 58.928, \"score\": 0.842}, {\"word\": \"高\", \"start\": 58.928, \"end\": 59.569, \"score\": 0.869}, {\"word\": \"可\", \"start\": 59.569, \"end\": 59.669, \"score\": 0.903}, {\"word\": \"是\", \"start\": 59.669, \"end\": 59.809, \"score\": 0.776}, {\"word\": \"我\", \"start\": 59.809, \"end\": 59.929, \"score\": 0.774}, {\"word\": \"們\"}, {\"word\": \"當\"}, {\"word\": \"然\", \"start\": 59.929, \"end\": 60.229, \"score\": 0.858}, {\"word\": \"希\", \"start\": 60.229, \"end\": 60.329, \"score\": 0.919}, {\"word\": \"望\", \"start\": 60.329, \"end\": 60.97, \"score\": 0.906}, {\"word\": \"長\"}, {\"word\": \"照\", \"start\": 60.97, \"end\": 61.711, \"score\": 0.852}, {\"word\": \"3\"}, {\"word\": \".\"}, {\"word\": \"0\"}, {\"word\": \"可\", \"start\": 61.711, \"end\": 61.811, \"score\": 0.811}, {\"word\": \"以\", \"start\": 61.811, \"end\": 61.951, \"score\": 0.996}, {\"word\": \"更\", \"start\": 61.951, \"end\": 62.151, \"score\": 0.972}, {\"word\": \"好\", \"start\": 62.151, \"end\": 62.411, \"score\": 0.947}, {\"word\": \"的\", \"start\": 62.411, \"end\": 63.392, \"score\": 0.928}, {\"word\": \"話\"}, {\"word\": \"那\", \"start\": 63.392, \"end\": 63.672, \"score\": 0.995}, {\"word\": \"就\", \"start\": 63.672, \"end\": 63.953, \"score\": 0.992}, {\"word\": \"想\", \"start\": 63.953, \"end\": 65.694, \"score\": 0.934}, {\"word\": \"來\"}, {\"word\": \"問\"}, {\"word\": \"就\", \"start\": 65.694, \"end\": 65.774, \"score\": 0.841}, {\"word\": \"是\", \"start\": 65.774, \"end\": 66.054, \"score\": 0.728}, {\"word\": \"衛\"}, {\"word\": \"福\", \"start\": 66.054, \"end\": 66.195, \"score\": 0.858}, {\"word\": \"部\", \"start\": 66.195, \"end\": 66.775, \"score\": 0.963}, {\"word\": \"一\", \"start\": 66.775, \"end\": 66.915, \"score\": 0.998}, {\"word\": \"直\", \"start\": 66.915, \"end\": 67.035, \"score\": 0.835}, {\"word\": \"都\", \"start\": 67.035, \"end\": 67.135, \"score\": 0.998}, {\"word\": \"沒\", \"start\": 67.135, \"end\": 67.215, \"score\": 0.75}, {\"word\": \"有\", \"start\": 67.215, \"end\": 67.736, \"score\": 0.947}, {\"word\": \"對\"}, {\"word\": \"社\", \"start\": 67.736, \"end\": 68.016, \"score\": 0.834}, {\"word\": \"會\"}, {\"word\": \"好\", \"start\": 68.016, \"end\": 68.216, \"score\": 0.94}, {\"word\": \"好\", \"start\": 68.216, \"end\": 68.617, \"score\": 0.946}, {\"word\": \"說\"}, {\"word\": \"明\", \"start\": 68.617, \"end\": 69.397, \"score\": 0.926}, {\"word\": \"就\", \"start\": 69.397, \"end\": 69.518, \"score\": 0.801}, {\"word\": \"是\", \"start\": 69.518, \"end\": 69.778, \"score\": 0.922}, {\"word\": \"說\"}, {\"word\": \"社\", \"start\": 69.778, \"end\": 69.998, \"score\": 0.816}, {\"word\": \"會\"}, {\"word\": \"各\", \"start\": 69.998, \"end\": 70.779, \"score\": 0.921}, {\"word\": \"界\", \"start\": 70.779, \"end\": 70.939, \"score\": 0.934}, {\"word\": \"都\", \"start\": 70.939, \"end\": 71.059, \"score\": 0.998}, {\"word\": \"是\", \"start\": 71.059, \"end\": 71.579, \"score\": 0.838}, {\"word\": \"對\"}, {\"word\": \"長\"}, {\"word\": \"照\", \"start\": 71.579, \"end\": 72.22, \"score\": 0.859}, {\"word\": \"3\"}, {\"word\": \".\"}, {\"word\": \"0\"}, {\"word\": \"有\", \"start\": 72.22, \"end\": 72.48, \"score\": 0.985}, {\"word\": \"無\", \"start\": 72.48, \"end\": 72.68, \"score\": 0.859}, {\"word\": \"限\", \"start\": 72.68, \"end\": 72.981, \"score\": 0.943}, {\"word\": \"美\", \"start\": 72.981, \"end\": 73.161, \"score\": 0.92}, {\"word\": \"好\", \"start\": 73.161, \"end\": 73.401, \"score\": 0.987}, {\"word\": \"的\", \"start\": 73.401, \"end\": 73.601, \"score\": 0.996}, {\"word\": \"想\", \"start\": 73.601, \"end\": 73.881, \"score\": 0.97}, {\"word\": \"像\", \"start\": 73.881, \"end\": 73.901, \"score\": 0.149}]}, {\"start\": 74.782, \"end\": 96.455, \"text\": \"那可是當然也有更多的猜測至少明天團體是這樣就請問究竟什麼是長照3.0那是不是可以簡單說明我跟委員報告簡單三個重點第一個事實上就是因為賴先德中華自己本身也是醫生那邱部長他這邊也非常非常琢磨所以我們第一個重點事實上就是醫療與長照的結合\", \"words\": [{\"word\": \"那\", \"start\": 74.782, \"end\": 75.563, \"score\": 0.951}, {\"word\": \"可\", \"start\": 75.563, \"end\": 75.683, \"score\": 0.861}, {\"word\": \"是\", \"start\": 75.683, \"end\": 75.843, \"score\": 0.885}, {\"word\": \"當\"}, {\"word\": \"然\", \"start\": 75.843, \"end\": 76.023, \"score\": 0.833}, {\"word\": 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{\"word\": \"究\", \"start\": 79.505, \"end\": 79.725, \"score\": 0.901}, {\"word\": \"竟\", \"start\": 79.725, \"end\": 80.726, \"score\": 0.979}, {\"word\": \"什\", \"start\": 80.726, \"end\": 81.006, \"score\": 0.91}, {\"word\": \"麼\"}, {\"word\": \"是\", \"start\": 81.006, \"end\": 81.706, \"score\": 0.944}, {\"word\": \"長\"}, {\"word\": \"照\", \"start\": 81.706, \"end\": 83.447, \"score\": 0.885}, {\"word\": \"3\"}, {\"word\": \".\"}, {\"word\": \"0\"}, {\"word\": \"那\", \"start\": 83.447, \"end\": 83.667, \"score\": 0.867}, {\"word\": \"是\", \"start\": 83.667, \"end\": 83.747, \"score\": 0.753}, {\"word\": \"不\", \"start\": 83.747, \"end\": 83.767, \"score\": 0.113}, {\"word\": \"是\", \"start\": 83.767, \"end\": 83.847, \"score\": 0.686}, {\"word\": \"可\", \"start\": 83.847, \"end\": 83.907, \"score\": 0.966}, {\"word\": \"以\", \"start\": 83.907, \"end\": 84.448, \"score\": 0.844}, {\"word\": \"簡\"}, {\"word\": \"單\"}, {\"word\": \"說\"}, {\"word\": \"明\", \"start\": 84.448, \"end\": 85.228, \"score\": 0.883}, {\"word\": \"我\", \"start\": 85.228, \"end\": 85.328, \"score\": 0.786}, {\"word\": \"跟\", \"start\": 85.328, \"end\": 85.568, \"score\": 0.826}, {\"word\": \"委\", \"start\": 85.568, \"end\": 86.069, \"score\": 0.871}, {\"word\": \"員\"}, {\"word\": \"報\"}, {\"word\": \"告\", \"start\": 86.069, \"end\": 86.689, \"score\": 0.874}, {\"word\": \"簡\"}, {\"word\": \"單\"}, {\"word\": \"三\", \"start\": 86.689, \"end\": 86.889, \"score\": 0.825}, {\"word\": \"個\"}, {\"word\": \"重\", \"start\": 86.889, \"end\": 87.71, \"score\": 0.895}, {\"word\": \"點\"}, {\"word\": \"第\", \"start\": 87.71, \"end\": 87.79, \"score\": 0.999}, {\"word\": \"一\", \"start\": 87.79, \"end\": 88.09, \"score\": 0.878}, {\"word\": \"個\"}, {\"word\": \"事\", \"start\": 88.09, \"end\": 88.31, \"score\": 0.87}, {\"word\": \"實\"}, {\"word\": \"上\", \"start\": 88.31, \"end\": 88.55, \"score\": 0.989}, {\"word\": \"就\", \"start\": 88.55, \"end\": 88.67, \"score\": 0.997}, {\"word\": \"是\", \"start\": 88.67, \"end\": 88.77, \"score\": 0.905}, {\"word\": \"因\", \"start\": 88.77, \"end\": 89.311, \"score\": 0.877}, {\"word\": \"為\"}, {\"word\": \"賴\"}, {\"word\": \"先\", \"start\": 89.311, \"end\": 89.431, \"score\": 0.707}, {\"word\": \"德\", \"start\": 89.431, \"end\": 89.531, \"score\": 0.796}, {\"word\": \"中\", \"start\": 89.531, \"end\": 89.851, \"score\": 0.876}, {\"word\": \"華\"}, {\"word\": \"自\", \"start\": 89.851, \"end\": 89.911, \"score\": 0.879}, {\"word\": \"己\", \"start\": 89.911, \"end\": 89.991, \"score\": 0.856}, {\"word\": \"本\", \"start\": 89.991, \"end\": 90.091, \"score\": 0.993}, {\"word\": \"身\", \"start\": 90.091, \"end\": 90.531, \"score\": 0.855}, {\"word\": \"也\", \"start\": 90.531, \"end\": 90.651, \"score\": 0.996}, {\"word\": \"是\", \"start\": 90.651, \"end\": 90.932, \"score\": 0.859}, {\"word\": \"醫\"}, {\"word\": \"生\", \"start\": 90.932, \"end\": 91.712, \"score\": 0.84}, {\"word\": \"那\", \"start\": 91.712, \"end\": 93.153, \"score\": 0.945}, {\"word\": \"邱\", \"start\": 93.153, \"end\": 93.253, \"score\": 0.765}, {\"word\": \"部\", \"start\": 93.253, \"end\": 93.573, \"score\": 0.88}, {\"word\": \"長\"}, {\"word\": \"他\", \"start\": 93.573, \"end\": 94.133, \"score\": 0.868}, {\"word\": \"這\"}, {\"word\": \"邊\"}, {\"word\": \"也\", \"start\": 94.133, \"end\": 94.274, \"score\": 0.995}, {\"word\": \"非\", \"start\": 94.274, \"end\": 94.354, \"score\": 0.907}, {\"word\": \"常\", \"start\": 94.354, \"end\": 94.494, \"score\": 0.855}, {\"word\": \"非\", \"start\": 94.494, \"end\": 94.714, \"score\": 0.833}, {\"word\": \"常\", \"start\": 94.714, \"end\": 94.834, \"score\": 0.827}, {\"word\": \"琢\"}, {\"word\": \"磨\", \"start\": 94.834, \"end\": 95.014, \"score\": 0.889}, {\"word\": \"所\", \"start\": 95.014, \"end\": 95.074, \"score\": 0.667}, {\"word\": \"以\", \"start\": 95.074, \"end\": 95.154, \"score\": 0.683}, {\"word\": \"我\", \"start\": 95.154, \"end\": 95.434, \"score\": 0.927}, {\"word\": \"們\"}, {\"word\": \"第\", \"start\": 95.434, \"end\": 95.534, \"score\": 0.999}, {\"word\": \"一\", \"start\": 95.534, \"end\": 95.694, \"score\": 0.86}, {\"word\": \"個\"}, {\"word\": \"重\", \"start\": 95.694, \"end\": 95.955, \"score\": 0.898}, {\"word\": \"點\"}, {\"word\": \"事\", \"start\": 95.955, \"end\": 96.035, \"score\": 0.952}, {\"word\": \"實\"}, {\"word\": \"上\", \"start\": 96.035, \"end\": 96.175, \"score\": 0.857}, {\"word\": \"就\", \"start\": 96.175, \"end\": 96.235, \"score\": 0.984}, {\"word\": \"是\", \"start\": 96.235, \"end\": 96.255, \"score\": 0.0}, {\"word\": \"醫\"}, {\"word\": \"療\"}, {\"word\": \"與\"}, {\"word\": \"長\"}, {\"word\": \"照\", \"start\": 96.255, \"end\": 96.275, \"score\": 0.0}, {\"word\": \"的\", \"start\": 96.275, \"end\": 96.435, \"score\": 0.876}, {\"word\": \"結\"}, {\"word\": \"合\", \"start\": 96.435, \"end\": 96.455, \"score\": 0.0}]}, {\"start\": 98.676, \"end\": 126.736, \"text\": \"那這裡面具體來說就兩個重點第一個就是PAC就是即興後期另外第二個部分事實上就是有跟大家一計畫的導入所以這第一個重點第二個是積極賦能我們希望我們的長輩他不僅僅只是這一個長照而已而且甚至如果盡可能的話他甚至還可以改善他的整個這一個照顧等級所以賦能不光復健是賦能的部分第三個事實上就是整個所謂的我們所謂安寧善終的概念我們希望我們每位長輩\", \"words\": [{\"word\": \"那\", \"start\": 98.676, \"end\": 98.956, \"score\": 0.649}, {\"word\": \"這\"}, {\"word\": \"裡\"}, {\"word\": \"面\", \"start\": 98.956, \"end\": 99.777, \"score\": 0.968}, {\"word\": \"具\", \"start\": 99.777, \"end\": 100.197, \"score\": 0.705}, {\"word\": \"體\"}, {\"word\": \"來\"}, {\"word\": \"說\"}, {\"word\": \"就\", \"start\": 100.197, \"end\": 100.497, \"score\": 0.718}, {\"word\": \"兩\"}, {\"word\": \"個\"}, {\"word\": \"重\", \"start\": 100.497, \"end\": 100.838, \"score\": 0.854}, {\"word\": \"點\"}, {\"word\": \"第\", \"start\": 100.838, \"end\": 100.918, \"score\": 0.988}, {\"word\": \"一\", \"start\": 100.918, \"end\": 101.078, \"score\": 0.612}, {\"word\": \"個\"}, {\"word\": \"就\", \"start\": 101.078, \"end\": 101.178, \"score\": 0.837}, {\"word\": \"是\", \"start\": 101.178, \"end\": 101.258, \"score\": 0.638}, {\"word\": \"P\", \"start\": 101.258, \"end\": 101.278, \"score\": 0.0}, {\"word\": \"A\", \"start\": 101.278, \"end\": 101.498, \"score\": 0.765}, {\"word\": \"C\", \"start\": 101.498, \"end\": 102.619, \"score\": 0.872}, {\"word\": \"就\", \"start\": 102.619, \"end\": 102.719, \"score\": 0.95}, {\"word\": \"是\", \"start\": 102.719, \"end\": 102.859, \"score\": 0.841}, {\"word\": \"即\", \"start\": 102.859, \"end\": 103.44, \"score\": 0.799}, {\"word\": \"興\"}, {\"word\": \"後\", \"start\": 103.44, \"end\": 103.68, \"score\": 0.725}, {\"word\": \"期\", \"start\": 103.68, \"end\": 104.42, \"score\": 0.903}, {\"word\": \"另\", \"start\": 104.42, \"end\": 104.5, \"score\": 0.917}, {\"word\": \"外\", \"start\": 104.5, \"end\": 104.64, \"score\": 0.802}, {\"word\": \"第\", \"start\": 104.64, \"end\": 104.741, \"score\": 0.856}, {\"word\": \"二\", \"start\": 104.741, \"end\": 104.901, \"score\": 0.552}, {\"word\": \"個\"}, {\"word\": \"部\", \"start\": 104.901, \"end\": 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{\"word\": \"長\"}], \"language\": \"zh\"}","srt":"1\n00:00:06,722 --> 00:00:35,047\n主席有請那個呂次長好次長市長早委員長好市長因應我們的長照需求減輕家庭負擔我們在2017年就推動了長照10年的計畫那現在為了我們的實踐總統的建立台灣的國政願景呢事實上\n\n2\n00:00:35,546 --> 00:00:50,819\n要優化長照2.0來啟動長照3.0你們3月份也開始去做這樣子的一個討論希望摒除掉長照2.0的一些比較不OK的狀態裡邊然後能夠去優化然後來提出長照3.0\n\n3\n00:00:52,082 --> 00:01:13,901\n所以看起來不只是我覺得量的問題跟值得提升看你們報告看起來事實上是大家滿意度也非常高可是我們當然希望長照3.0可以更好的話那就想來問就是衛福部一直都沒有對社會好好說明就是說社會各界都是對長照3.0有無限美好的想像\n\n4\n00:01:14,782 --> 00:01:36,455\n那可是當然也有更多的猜測至少明天團體是這樣就請問究竟什麼是長照3.0那是不是可以簡單說明我跟委員報告簡單三個重點第一個事實上就是因為賴先德中華自己本身也是醫生那邱部長他這邊也非常非常琢磨所以我們第一個重點事實上就是醫療與長照的結合\n\n5\n00:01:38,676 --> 00:02:06,736\n那這裡面具體來說就兩個重點第一個就是PAC就是即興後期另外第二個部分事實上就是有跟大家一計畫的導入所以這第一個重點第二個是積極賦能我們希望我們的長輩他不僅僅只是這一個長照而已而且甚至如果盡可能的話他甚至還可以改善他的整個這一個照顧等級所以賦能不光復健是賦能的部分第三個事實上就是整個所謂的我們所謂安寧善終的概念我們希望我們每位長輩\n\n6\n00:02:07,737 --> 00:02:24,203\n或者我們每位被照顧的一個長輩他都能夠有一個最好的一個照顧所以簡單來說這三個重點次長你這樣講的話就是因為從你的書面報告裡面列出了八大目標嘛所以我就換個角度來問像你剛剛提的\n\n7\n00:02:27,385 --> 00:02:47,046\n這到底是不是你的政策亮點因為我覺得如果從8A目標裡面去看勉強如果講亮點的話就導入智慧照顧跟落實安寧善終之外可是你剛剛講大家醫這些那這是不是你長照3.0的政策亮點嗎或者你現在可不可以講說具體你們的政策亮點是什麼\n\n8\n00:02:48,381 --> 00:03:11,250\n我也必須要跟委員報告啦因為現在目前就是我們現在目前整個的計畫都已經送到行政院那行政院現在目前我們要等待他的這個核定但是如果說我現在可以透露的話主要就是委員剛剛所說的就是剛剛說的大嘉義計畫裡面因為我們現在也會非常重要是希望就是說我們的照顧能夠盡可能的也能夠提供到居家\n\n9\n00:03:11,990 --> 00:03:36,837\n所以我們到時候像部長他是就是大家一計劃裡面我們有關於那個有關居家照顧的這部分還有像是室長他一直都在推動有關HAH的這一個部分我們去年也已經推動了這一個在來急症照護在這個基礎上面我們會來來往就是整個這一個居家的這一個的這一個醫療照顧的部分來推動\n\n10\n00:03:39,619 --> 00:03:45,508\n因為在有限的裁員底下勢必要集中資源來擴大服務對象避免重複的開銷\n\n11\n00:03:48,581 --> 00:04:11,907\n同時也可以增加服務項目所以達到1加1等於2的效果這是市政的ABC那所以民間大也是期待就是說醫療跟社福接下來方向長照應該是說醫療跟社福是不是可以整合在社區裡邊那當然我們更希望擴大服務對象兒少老夫這樣是不是可以都納入所以我覺得長照是不是可以去整合到居家社區跟醫療社福\n\n12\n00:04:13,686 --> 00:04:36,592\n甚至連續性照顧的服務來擴大服務對象增加服務項目所以我就要問市長這邊想問的是首先原本整合的事實上是我們的身障跟腸整合進去所以那個身障的服務那同時我們也看到這兩個服務但事實上是某些部分類似的項目可以互相替代可是\n\n13\n00:04:37,185 --> 00:04:51,087\n像居家服務跟個住可是實務上卻有我們現在就最近是收到一些案子就是說像成古部全鎮也就俗稱玻璃娃娃的藏友們他本身通過了ICF的鑑定\n\n14\n00:04:52,270 --> 00:05:15,578\n也就是它事實上是重度障礙的可是沒有辦法通過你們的CNS因為這個CNS評估說它是健康那就讓民眾無法理解所以我覺得本席是認為說衛福部是不是要先解決你們很多的評估CNSCDRICFADLIADL的各種評估相互競合的問題你怎麼做\n\n15\n00:05:19,124 --> 00:05:43,549\n這幾個這麼多的不同的那你們這邊有這麼多的那你看評估又不一樣喔那就像我剛剛講的這個陳骨部全政一個評估說他健康一個評估說他重度腸臟那他到底可不可以用腸臟呢報告報告委員威強委員確實也點出一個重點現在目前就是說這個評估的量表非常多不過我也跟委員報告現在就是說就個案的本身而言他的病程其實在每個階段都會有他不同的這個變化\n\n16\n00:05:45,745 --> 00:05:57,385\n就是他的整個這個他的病程的發展的階段其實事實上還是可是不會落差這麼的大因為一個評估事實上是重度產生一個事實上是\n\n17\n00:05:58,275 --> 00:06:19,857\n健康我覺得這落差太大了但我們承認有時候病程不一樣可是他本身的狀態他本來就是玻璃瓦花那所以我覺得你們是不是要去討論一下這評估量表之間的落差度跟進合那另外就是針對於我們的身臟的日照跟長照日照整合\n\n18\n00:06:20,397 --> 00:06:43,092\n去年我就提過了照顧人員資格的問題我們有跟你們就教就是衛福部那時候表示說照顧服務人員定義要放寬納入照顧服務員照保員跟生活服務員不去干涉各項職別的高低因為去年有發生過一些問題所以要去修正我們的長照服務人員訓練認證繼續教育跟登錄辦法請問一下進度如何\n\n19\n00:06:47,214 --> 00:07:09,051\n報告委員我知道委員一直以來都對這個問題非常關心那我覺得確實這是一個痛點所以我們也根據委員的一個建議我們現在目前已經在預告我們現在目前已經進入到預告階段那收集各方意見之後我想我們就是委員的建議非常好我們要朝這個方向我們來推進因為這些人都待在機構裡面明明真的不太一樣他們的權益會受到損傷\n\n20\n00:07:10,552 --> 00:07:22,290\n那另外就來問是2023年的話平均每位照顧服務員的照顧人數是平均10.8位個案合理的話事實上是5到7所以這已經超過了可是超過以外\n\n21\n00:07:23,430 --> 00:07:45,841\n你的平均台北市苗栗縣雲林縣澎湖縣基隆市新竹市金門連江縣都高過平均數位所以就要想來問部長幾個問題第一個照顧產業的人事成本大概佔六成以上長照就是人力密集的產業當下人力顯然是不足的話政府怎麼去因應這個問題\n\n22\n00:07:46,701 --> 00:08:08,331\n包委員我想我們現在目前在整個3.0裡面有三個主要的策略第一個其實主要事實上還是薪資跟這一個勞動條件的一個改善第二個其實最重要事實上沒錯舉世皆然整個照顧服務其實上是一個levelintensive是一個高度高度需要勞動力所以這個部分我們主要是希望未來能夠引進這個輔具就是說整個輔具的這個引進能夠來大量來減輕他的譬如說\n\n23\n00:08:14,374 --> 00:08:39,826\n對沒錯譬如說現在機構裡面像有關於這個洗澡機這一個的使用第三個我跟委員報告我們未來會在整個這個造福園裡面我們事實上是會有分級就是說有高階有資深中階低階然後未來我們也會有一個整個跟這個部分公使彼此之間一個多元的一個交錯的一個策略來解決我們現在人力的問題\n\n24\n00:08:40,706 --> 00:08:47,390\n人力事實上還有個錢的問題就居家服務的照顧服務員的薪資目前月薪是3萬2\n\n25\n00:08:49,209 --> 00:09:11,819\n那時薪是200政府有調新的規劃嗎報告委員我們現在目前這個部分我也有薪資這個我們大家都非常關心那如果財政上如果可以允許我們當然會但是現在我也必須要報告委員我們現在目前其實居福的部分我想要舉一個最簡單的數據在2.0的時候其實當時是25433我們在去年已經突破10萬\n\n26\n00:09:17,816 --> 00:09:42,466\n已經突破10萬了那這個人數增加表示就是說我也跟各位報告他在這一個2.0在1.0的時候平均薪資是25K到現在已經是4萬所以這個事實上薪資事實上是在調升當中那也也顯見就是說他事實上是一個居福事實上是一個未來有前景的一個產業是那我們這個部分意思是說現在目前就是沒還沒有規劃到這邊後邊要看財政的狀況是嗎\n\n27\n00:09:43,325 --> 00:10:07,242\n我們會透過各項的一個整個這一個機制也會在也會跟部長部長其實也非常非常關心這個部分他也一直在強調其實要讓我們的這個長照做得好其實事實上整個薪資我們在財政允許的部分我們一定會來全力來推動好的那政府鼓勵我們的住宿型機構提供長照科系的學生\n\n28\n00:10:07,762 --> 00:10:14,236\n有實習的機會來提高我們的留用率那請問取得照顧服務員資格的實習生實習過程當中\n\n29\n00:10:16,226 --> 00:10:38,071\n得以占機構人力比嗎這件事有確定嗎我們已經確定了在本國的這部分我們已經確定了我們也認為這個事實上是應該推動的方向如果沒有得到兆福園資格的實習生占部分人力比目前的研議狀況如何包委員這個部分恐怕就我們現在暫時覺得可能是有疑慮\n\n30\n00:10:40,111 --> 00:10:58,671\n那長遠來看的話衛福部將擴大住宿型機構的移工的聘僱人數可是蘭嶺移工的聘僱跟產業類的移工事實上是競爭人數成長有限那中階的技術人力跟在台的留學生人數也有限所以對此衛福部有什麼對策\n\n31\n00:10:59,392 --> 00:11:23,272\n包委我們就是陳虎剛剛說的我們未來那個人力裡面除了我們的這個薪資提高之外來流入本勞之外另外我們也會從新南向國家就剛剛說的中介勞動力我們會來加強引進那從去年開始已經從這一個越南已經有引進那我們今年也會開始從印尼這邊那他只要在這邊服務滿6年那他就可以取得我們的永居\n\n32\n00:11:23,792 --> 00:11:32,654\n那我就要再問一個居服員大多數是反對機構併僱移工的衛福部對此有開放移工的規劃嗎\n\n33\n00:11:35,157 --> 00:11:54,676\n居府的部分現在目前還沒有居府的部分目前還沒有我們也知道本國我們的這個居府員他是現在這個疑慮但這部分我們當然我們只限住宿的部分而已因為住宿特別是夜間夜間人力的部分所以現在居府的這一塊沒有居府的部分我們是以目前我們現在就是本國\n\n34\n00:11:57,350 --> 00:12:20,845\n但是我跟委員報告現在就是說但是機構的部分確實在夜間的部分這個我想本國的這一個居服員他可能有一些偏好的問題所以這個部分我們就是優先我們會從這個外籍的中階勞動力來補儲這個部分那再來問數數型機構量能不足沒有辦法滿足10萬人的需求\n\n35\n00:12:21,706 --> 00:12:37,647\n所以政府持續對於公社興建跟公社協力的興建機構做補助去年中旬就有從事長照服務的盈利單位股票上市這是市場自然發生的趨勢之一可是一直以來\n\n36\n00:12:38,327 --> 00:12:53,134\n礙於老福法的三不政策住宿型機構未能納入到廠商支付的對象包括健保在宅醫療支付項目都受到限制所以想問為何不面對到我們這種日漸多元的市場經營模式的話實在有必要調整\n\n37\n00:12:54,574 --> 00:13:05,858\n以非營利為主的政策方向來建立適度的引入我們的營利機構服務量能的方法對此政府有沒有什麼樣的規劃其實我們在整個49層以下我們在在宅那個部分其實\n\n38\n00:13:10,840 --> 00:13:37,328\n提升計畫裡面那邊我們事實上是有的這是第一我跟委員說明一下那至於您剛剛所說的就是未來有關於這個機構的部分我們會未來我覺得49床其實也是我們非常重要的一個未來3.0非常重要的一個省力軍因為它的加速也事實上夠多那我們未來要建構一個10分鐘照顧圈我覺得一定是這個49床以下這個機構一定要進來所以我們也會加強這部分的一個整個補助跟輔導\n\n39\n00:13:38,268 --> 00:14:07,386\n好最後就請部長是不是可以針對我接下來這3.0的強烈建議希望政策方向請拜託跟人民說明清楚讓人民充分的去了解否則很多民軍團體也在猜到底你們的政策細節內容到底是什麼還有評估量表相互轉換的時候這樣子的話會減少不同服務間重新評估的次數也沒有必要因為各種這麼多的量表而且評估出來的那個最後的結果也不太一樣\n\n40\n00:14:08,146 --> 00:14:34,557\n還有人力空缺我覺得禁書要提出解方沒有人力大家就沒有長照還有移工僱主住宿型機構使用者要給予服務的公平對待還有希望你能夠建立長照制度跟盈利機構之間的合作模式我想部長不知道這幾項是不是可以在一個月後大概給我一些你們後來做的做法的報告好的沒問題好謝謝部長謝謝林委員謝謝部長次長\n\n","tsv":"start\tend\ttext\n6722\t35047\t主席有請那個呂次長好 次長市長早 委員長好市長因應我們的長照需求減輕家庭負擔我們在2017年就推動了長照10年的計畫那現在為了我們的實踐總統的建立台灣的國政願景呢事實上\n35546\t50819\t要優化長照2.0來啟動長照3.0你們3月份也開始去做這樣子的一個討論希望摒除掉長照2.0的一些比較不OK的狀態裡邊然後能夠去優化然後來提出長照3.0\n52082\t73901\t所以看起來不只是我覺得量的問題跟值得提升看你們報告看起來事實上是大家滿意度也非常高可是我們當然希望長照3.0可以更好的話那就想來問就是衛福部一直都沒有對社會好好說明就是說社會各界都是對長照3.0有無限美好的想像\n74782\t96455\t那可是當然也有更多的猜測至少明天團體是這樣就請問究竟什麼是長照3.0那是不是可以簡單說明我跟委員報告簡單三個重點第一個事實上就是因為賴先德中華自己本身也是醫生那邱部長他這邊也非常非常琢磨所以我們第一個重點事實上就是醫療與長照的結合\n98676\t126736\t那這裡面具體來說就兩個重點第一個就是PAC就是即興後期另外第二個部分事實上就是有跟大家一計畫的導入所以這第一個重點第二個是積極賦能我們希望我們的長輩他不僅僅只是這一個長照而已而且甚至如果盡可能的話他甚至還可以改善他的整個這一個照顧等級所以賦能不光復健是賦能的部分第三個事實上就是整個所謂的我們所謂安寧善終的概念我們希望我們每位長輩\n127737\t144203\t或者我們每位被照顧的一個長輩他都能夠有一個最好的一個照顧所以簡單來說這三個重點次長你這樣講的話就是因為從你的書面報告裡面列出了八大目標嘛所以我就換個角度來問像你剛剛提的\n147385\t167046\t這到底是不是你的政策亮點 因為我覺得如果從8A目標裡面去看 勉強如果講亮點的話就導入智慧照顧跟落實安寧善終之外可是你剛剛講大家醫這些 那這是不是你長照3.0的政策亮點嗎或者你現在可不可以講說 具體你們的政策亮點是什麼\n168381\t191250\t我也必須要跟委員報告啦因為現在目前就是我們現在目前整個的計畫都已經送到行政院那行政院現在目前我們要等待他的這個核定但是如果說我現在可以透露的話主要就是委員剛剛所說的就是剛剛說的大嘉義計畫裡面因為我們現在也會非常重要是希望就是說我們的照顧能夠盡可能的也能夠提供到居家\n191990\t216837\t所以我們到時候像部長他是就是大家一計劃裡面我們有關於那個有關居家照顧的這部分還有像是室長他一直都在推動有關HAH的這一個部分我們去年也已經推動了這一個在來急症照護在這個基礎上面我們會來來往就是整個這一個居家的這一個的這一個醫療照顧的部分來推動\n219619\t225508\t因為在有限的裁員底下勢必要集中資源來擴大服務對象避免重複的開銷\n228581\t251907\t同時也可以增加服務項目所以達到1加1等於2的效果這是市政的ABC那所以民間大也是期待就是說醫療跟社福接下來方向長照應該是說醫療跟社福是不是可以整合在社區裡邊那當然我們更希望擴大服務對象兒少老夫這樣是不是可以都納入所以我覺得長照是不是可以去整合到居家社區跟醫療社福\n253686\t276592\t甚至連續性照顧的服務來擴大服務對象增加服務項目所以我就要問市長這邊想問的是首先原本整合的事實上是我們的身障跟腸整合進去所以那個身障的服務那同時我們也看到這兩個服務但事實上是某些部分類似的項目可以互相替代可是\n277185\t291087\t像居家服務跟個住可是實務上卻有我們現在就最近是收到一些案子就是說像成古部全鎮也就俗稱玻璃娃娃的藏友們他本身通過了ICF的鑑定\n292270\t315578\t也就是它事實上是重度障礙的可是沒有辦法通過你們的CNS因為這個CNS評估說它是健康那就讓民眾無法理解所以我覺得本席是認為說衛福部是不是要先解決你們很多的評估CNS CDR ICF ADL IADL的各種評估相互競合的問題你怎麼做\n319124\t343549\t這幾個這麼多的不同的那你們這邊有這麼多的那你看評估又不一樣喔那就像我剛剛講的這個陳骨部全政一個評估說他健康一個評估說他重度腸臟那他到底可不可以用腸臟呢報告 報告委員威強委員確實也點出一個重點現在目前就是說這個評估的量表非常多不過我也跟委員報告現在就是說就個案的本身而言他的病程其實在每個階段都會有他不同的這個變化\n345745\t357385\t就是他的整個這個他的病程的發展的階段其實事實上還是可是不會落差這麼的大因為一個評估事實上是重度產生一個事實上是\n358275\t379857\t健康我覺得這落差太大了但我們承認有時候病程不一樣可是他本身的狀態他本來就是玻璃瓦花那所以我覺得你們是不是要去討論一下這評估量表之間的落差度跟進合那另外就是針對於我們的身臟的日照跟長照日照整合\n380397\t403092\t去年我就提過了照顧人員資格的問題我們有跟你們就教就是衛福部那時候表示說照顧服務人員定義要放寬納入照顧服務員 照保員跟生活服務員不去干涉各項職別的高低因為去年有發生過一些問題所以要去修正我們的長照服務人員訓練認證繼續教育跟登錄辦法請問一下進度如何\n407214\t429051\t報告委員 我知道委員一直以來都對這個問題非常關心 那我覺得確實這是一個痛點所以我們也根據委員的一個建議 我們現在目前已經在預告我們現在目前已經進入到預告階段 那收集各方意見之後我想我們就是委員的建議非常好 我們要朝這個方向 我們來推進因為這些人都待在機構裡面 明明真的不太一樣 他們的權益會受到損傷\n430552\t442290\t那另外就來問是2023年的話平均每位照顧服務員的照顧人數是平均10.8位個案合理的話事實上是5到7所以這已經超過了可是超過以外\n443430\t465841\t你的平均台北市苗栗縣雲林縣澎湖縣基隆市新竹市金門連江縣都高過平均數位所以就要想來問部長幾個問題第一個照顧產業的人事成本大概佔六成以上長照就是人力密集的產業當下人力顯然是不足的話政府怎麼去因應這個問題\n466701\t488331\t包委員我想我們現在目前在整個3.0裡面有三個主要的策略第一個其實主要事實上還是薪資跟這一個勞動條件的一個改善第二個其實最重要事實上沒錯舉世皆然整個照顧服務其實上是一個level intensive是一個高度高度需要勞動力所以這個部分我們主要是希望未來能夠引進這個輔具就是說整個輔具的這個引進能夠來大量來減輕他的譬如說\n494374\t519826\t對 沒錯 譬如說現在機構裡面像有關於這個洗澡機這一個的使用第三個 我跟委員報告我們未來會在整個這個造福園裡面我們事實上是會有分級就是說有高階 有資深 中階 低階然後未來我們也會有一個整個跟這個部分公使彼此之間一個多元的一個交錯的一個策略來解決我們現在人力的問題\n520706\t527390\t人力事實上還有個錢的問題就居家服務的照顧服務員的薪資目前月薪是3萬2\n529209\t551819\t那時薪是200政府有調新的規劃嗎報告委員我們現在目前這個部分我也有薪資這個我們大家都非常關心那如果財政上如果可以允許我們當然會但是現在我也必須要報告委員我們現在目前其實居福的部分我想要舉一個最簡單的數據在2.0的時候其實當時是25433我們在去年已經突破10萬\n557816\t582466\t已經突破10萬了那這個人數增加表示就是說我也跟各位報告他在這一個2.0在1.0的時候平均薪資是25K到現在已經是4萬所以這個事實上薪資事實上是在調升當中那也也顯見就是說他事實上是一個居福事實上是一個未來有前景的一個產業是那我們這個部分意思是說現在目前就是沒還沒有規劃到這邊後邊要看財政的狀況是嗎\n583325\t607242\t我們會透過各項的一個整個這一個機制也會在也會跟部長部長其實也非常非常關心這個部分他也一直在強調其實要讓我們的這個長照做得好其實事實上整個薪資我們在財政允許的部分我們一定會來全力來推動好的那政府鼓勵我們的住宿型機構提供長照科系的學生\n607762\t614236\t有實習的機會來提高我們的留用率那請問取得照顧服務員資格的實習生實習過程當中\n616226\t638071\t得以占機構人力比嗎 這件事有確定嗎我們已經確定了 在本國的這部分我們已經確定了我們也認為這個事實上是應該推動的方向如果沒有得到兆福園資格的實習生占部分人力比目前的研議狀況如何包委員這個部分恐怕就我們現在暫時覺得可能是有疑慮\n640111\t658671\t那長遠來看的話衛福部將擴大住宿型機構的移工的聘僱人數可是蘭嶺移工的聘僱跟產業類的移工事實上是競爭人數成長有限那中階的技術人力跟在台的留學生人數也有限所以對此衛福部有什麼對策\n659392\t683272\t包委我們就是陳虎剛剛說的我們未來那個人力裡面除了我們的這個薪資提高之外來流入本勞之外另外我們也會從新南向國家就剛剛說的中介勞動力我們會來加強引進那從去年開始已經從這一個越南已經有引進那我們今年也會開始從印尼這邊那他只要在這邊服務滿6年那他就可以取得我們的永居\n683792\t692654\t那我就要再問一個居服員大多數是反對機構併僱移工的衛福部對此有開放移工的規劃嗎\n695157\t714676\t居府的部分現在目前還沒有居府的部分目前還沒有我們也知道本國我們的這個居府員他是現在這個疑慮但這部分我們當然我們只限住宿的部分而已因為住宿特別是夜間夜間人力的部分所以現在居府的這一塊沒有居府的部分我們是以目前我們現在就是本國\n717350\t740845\t但是我跟委員報告 現在就是說 但是機構的部分確實在夜間的部分這個我想本國的這一個居服員他可能有一些偏好的問題所以這個部分我們就是優先我們會從這個外籍的中階勞動力來補儲這個部分那再來問 數數型機構量能不足沒有辦法滿足10萬人的需求\n741706\t757647\t所以政府持續對於公社興建跟公社協力的興建機構做補助去年中旬就有從事長照服務的盈利單位股票上市這是市場自然發生的趨勢之一可是一直以來\n758327\t773134\t礙於老福法的三不政策 住宿型機構未能納入到廠商支付的對象 包括健保 在宅醫療支付項目都受到限制所以想問 為何不面對到我們這種日漸多元的市場經營模式的話 實在有必要調整\n774574\t785858\t以非營利為主的政策方向來建立適度的引入我們的營利機構服務量能的方法對此政府有沒有什麼樣的規劃其實我們在整個49層以下我們在在宅那個部分其實\n790840\t817328\t提升計畫裡面 那邊我們事實上是有的這是第一 我跟委員說明一下那至於您剛剛所說的就是未來有關於這個機構的部分我們會未來 我覺得49床其實也是我們非常重要的一個未來3.0非常重要的一個省力軍因為它的加速也事實上夠多那我們未來要建構一個10分鐘照顧圈我覺得一定是這個49床以下這個機構一定要進來所以我們也會加強這部分的一個整個補助跟輔導\n818268\t847386\t好最後就請部長是不是可以針對我接下來這3.0的強烈建議希望政策方向請拜託跟人民說明清楚讓人民充分的去了解否則很多民軍團體也在猜到底你們的政策細節內容到底是什麼還有評估量表相互轉換的時候這樣子的話會減少不同服務間重新評估的次數也沒有必要因為各種這麼多的量表而且評估出來的那個最後的結果也不太一樣\n848146\t874557\t還有人力空缺 我覺得禁書要提出解方沒有人力大家就沒有長照還有移工僱主 住宿型機構使用者要給予服務的公平對待還有希望你能夠建立長照制度跟盈利機構之間的合作模式我想部長不知道這幾項是不是可以在一個月後大概給我一些你們後來做的做法的報告好的 沒問題好 謝謝部長謝謝林委員 謝謝部長 次長\n","txt":"主席有請那個呂次長好 次長市長早 委員長好市長因應我們的長照需求減輕家庭負擔我們在2017年就推動了長照10年的計畫那現在為了我們的實踐總統的建立台灣的國政願景呢事實上\n要優化長照2.0來啟動長照3.0你們3月份也開始去做這樣子的一個討論希望摒除掉長照2.0的一些比較不OK的狀態裡邊然後能夠去優化然後來提出長照3.0\n所以看起來不只是我覺得量的問題跟值得提升看你們報告看起來事實上是大家滿意度也非常高可是我們當然希望長照3.0可以更好的話那就想來問就是衛福部一直都沒有對社會好好說明就是說社會各界都是對長照3.0有無限美好的想像\n那可是當然也有更多的猜測至少明天團體是這樣就請問究竟什麼是長照3.0那是不是可以簡單說明我跟委員報告簡單三個重點第一個事實上就是因為賴先德中華自己本身也是醫生那邱部長他這邊也非常非常琢磨所以我們第一個重點事實上就是醫療與長照的結合\n那這裡面具體來說就兩個重點第一個就是PAC就是即興後期另外第二個部分事實上就是有跟大家一計畫的導入所以這第一個重點第二個是積極賦能我們希望我們的長輩他不僅僅只是這一個長照而已而且甚至如果盡可能的話他甚至還可以改善他的整個這一個照顧等級所以賦能不光復健是賦能的部分第三個事實上就是整個所謂的我們所謂安寧善終的概念我們希望我們每位長輩\n或者我們每位被照顧的一個長輩他都能夠有一個最好的一個照顧所以簡單來說這三個重點次長你這樣講的話就是因為從你的書面報告裡面列出了八大目標嘛所以我就換個角度來問像你剛剛提的\n這到底是不是你的政策亮點 因為我覺得如果從8A目標裡面去看 勉強如果講亮點的話就導入智慧照顧跟落實安寧善終之外可是你剛剛講大家醫這些 那這是不是你長照3.0的政策亮點嗎或者你現在可不可以講說 具體你們的政策亮點是什麼\n我也必須要跟委員報告啦因為現在目前就是我們現在目前整個的計畫都已經送到行政院那行政院現在目前我們要等待他的這個核定但是如果說我現在可以透露的話主要就是委員剛剛所說的就是剛剛說的大嘉義計畫裡面因為我們現在也會非常重要是希望就是說我們的照顧能夠盡可能的也能夠提供到居家\n所以我們到時候像部長他是就是大家一計劃裡面我們有關於那個有關居家照顧的這部分還有像是室長他一直都在推動有關HAH的這一個部分我們去年也已經推動了這一個在來急症照護在這個基礎上面我們會來來往就是整個這一個居家的這一個的這一個醫療照顧的部分來推動\n因為在有限的裁員底下勢必要集中資源來擴大服務對象避免重複的開銷\n同時也可以增加服務項目所以達到1加1等於2的效果這是市政的ABC那所以民間大也是期待就是說醫療跟社福接下來方向長照應該是說醫療跟社福是不是可以整合在社區裡邊那當然我們更希望擴大服務對象兒少老夫這樣是不是可以都納入所以我覺得長照是不是可以去整合到居家社區跟醫療社福\n甚至連續性照顧的服務來擴大服務對象增加服務項目所以我就要問市長這邊想問的是首先原本整合的事實上是我們的身障跟腸整合進去所以那個身障的服務那同時我們也看到這兩個服務但事實上是某些部分類似的項目可以互相替代可是\n像居家服務跟個住可是實務上卻有我們現在就最近是收到一些案子就是說像成古部全鎮也就俗稱玻璃娃娃的藏友們他本身通過了ICF的鑑定\n也就是它事實上是重度障礙的可是沒有辦法通過你們的CNS因為這個CNS評估說它是健康那就讓民眾無法理解所以我覺得本席是認為說衛福部是不是要先解決你們很多的評估CNS CDR ICF ADL IADL的各種評估相互競合的問題你怎麼做\n這幾個這麼多的不同的那你們這邊有這麼多的那你看評估又不一樣喔那就像我剛剛講的這個陳骨部全政一個評估說他健康一個評估說他重度腸臟那他到底可不可以用腸臟呢報告 報告委員威強委員確實也點出一個重點現在目前就是說這個評估的量表非常多不過我也跟委員報告現在就是說就個案的本身而言他的病程其實在每個階段都會有他不同的這個變化\n就是他的整個這個他的病程的發展的階段其實事實上還是可是不會落差這麼的大因為一個評估事實上是重度產生一個事實上是\n健康我覺得這落差太大了但我們承認有時候病程不一樣可是他本身的狀態他本來就是玻璃瓦花那所以我覺得你們是不是要去討論一下這評估量表之間的落差度跟進合那另外就是針對於我們的身臟的日照跟長照日照整合\n去年我就提過了照顧人員資格的問題我們有跟你們就教就是衛福部那時候表示說照顧服務人員定義要放寬納入照顧服務員 照保員跟生活服務員不去干涉各項職別的高低因為去年有發生過一些問題所以要去修正我們的長照服務人員訓練認證繼續教育跟登錄辦法請問一下進度如何\n報告委員 我知道委員一直以來都對這個問題非常關心 那我覺得確實這是一個痛點所以我們也根據委員的一個建議 我們現在目前已經在預告我們現在目前已經進入到預告階段 那收集各方意見之後我想我們就是委員的建議非常好 我們要朝這個方向 我們來推進因為這些人都待在機構裡面 明明真的不太一樣 他們的權益會受到損傷\n那另外就來問是2023年的話平均每位照顧服務員的照顧人數是平均10.8位個案合理的話事實上是5到7所以這已經超過了可是超過以外\n你的平均台北市苗栗縣雲林縣澎湖縣基隆市新竹市金門連江縣都高過平均數位所以就要想來問部長幾個問題第一個照顧產業的人事成本大概佔六成以上長照就是人力密集的產業當下人力顯然是不足的話政府怎麼去因應這個問題\n包委員我想我們現在目前在整個3.0裡面有三個主要的策略第一個其實主要事實上還是薪資跟這一個勞動條件的一個改善第二個其實最重要事實上沒錯舉世皆然整個照顧服務其實上是一個level intensive是一個高度高度需要勞動力所以這個部分我們主要是希望未來能夠引進這個輔具就是說整個輔具的這個引進能夠來大量來減輕他的譬如說\n對 沒錯 譬如說現在機構裡面像有關於這個洗澡機這一個的使用第三個 我跟委員報告我們未來會在整個這個造福園裡面我們事實上是會有分級就是說有高階 有資深 中階 低階然後未來我們也會有一個整個跟這個部分公使彼此之間一個多元的一個交錯的一個策略來解決我們現在人力的問題\n人力事實上還有個錢的問題就居家服務的照顧服務員的薪資目前月薪是3萬2\n那時薪是200政府有調新的規劃嗎報告委員我們現在目前這個部分我也有薪資這個我們大家都非常關心那如果財政上如果可以允許我們當然會但是現在我也必須要報告委員我們現在目前其實居福的部分我想要舉一個最簡單的數據在2.0的時候其實當時是25433我們在去年已經突破10萬\n已經突破10萬了那這個人數增加表示就是說我也跟各位報告他在這一個2.0在1.0的時候平均薪資是25K到現在已經是4萬所以這個事實上薪資事實上是在調升當中那也也顯見就是說他事實上是一個居福事實上是一個未來有前景的一個產業是那我們這個部分意思是說現在目前就是沒還沒有規劃到這邊後邊要看財政的狀況是嗎\n我們會透過各項的一個整個這一個機制也會在也會跟部長部長其實也非常非常關心這個部分他也一直在強調其實要讓我們的這個長照做得好其實事實上整個薪資我們在財政允許的部分我們一定會來全力來推動好的那政府鼓勵我們的住宿型機構提供長照科系的學生\n有實習的機會來提高我們的留用率那請問取得照顧服務員資格的實習生實習過程當中\n得以占機構人力比嗎 這件事有確定嗎我們已經確定了 在本國的這部分我們已經確定了我們也認為這個事實上是應該推動的方向如果沒有得到兆福園資格的實習生占部分人力比目前的研議狀況如何包委員這個部分恐怕就我們現在暫時覺得可能是有疑慮\n那長遠來看的話衛福部將擴大住宿型機構的移工的聘僱人數可是蘭嶺移工的聘僱跟產業類的移工事實上是競爭人數成長有限那中階的技術人力跟在台的留學生人數也有限所以對此衛福部有什麼對策\n包委我們就是陳虎剛剛說的我們未來那個人力裡面除了我們的這個薪資提高之外來流入本勞之外另外我們也會從新南向國家就剛剛說的中介勞動力我們會來加強引進那從去年開始已經從這一個越南已經有引進那我們今年也會開始從印尼這邊那他只要在這邊服務滿6年那他就可以取得我們的永居\n那我就要再問一個居服員大多數是反對機構併僱移工的衛福部對此有開放移工的規劃嗎\n居府的部分現在目前還沒有居府的部分目前還沒有我們也知道本國我們的這個居府員他是現在這個疑慮但這部分我們當然我們只限住宿的部分而已因為住宿特別是夜間夜間人力的部分所以現在居府的這一塊沒有居府的部分我們是以目前我們現在就是本國\n但是我跟委員報告 現在就是說 但是機構的部分確實在夜間的部分這個我想本國的這一個居服員他可能有一些偏好的問題所以這個部分我們就是優先我們會從這個外籍的中階勞動力來補儲這個部分那再來問 數數型機構量能不足沒有辦法滿足10萬人的需求\n所以政府持續對於公社興建跟公社協力的興建機構做補助去年中旬就有從事長照服務的盈利單位股票上市這是市場自然發生的趨勢之一可是一直以來\n礙於老福法的三不政策 住宿型機構未能納入到廠商支付的對象 包括健保 在宅醫療支付項目都受到限制所以想問 為何不面對到我們這種日漸多元的市場經營模式的話 實在有必要調整\n以非營利為主的政策方向來建立適度的引入我們的營利機構服務量能的方法對此政府有沒有什麼樣的規劃其實我們在整個49層以下我們在在宅那個部分其實\n提升計畫裡面 那邊我們事實上是有的這是第一 我跟委員說明一下那至於您剛剛所說的就是未來有關於這個機構的部分我們會未來 我覺得49床其實也是我們非常重要的一個未來3.0非常重要的一個省力軍因為它的加速也事實上夠多那我們未來要建構一個10分鐘照顧圈我覺得一定是這個49床以下這個機構一定要進來所以我們也會加強這部分的一個整個補助跟輔導\n好最後就請部長是不是可以針對我接下來這3.0的強烈建議希望政策方向請拜託跟人民說明清楚讓人民充分的去了解否則很多民軍團體也在猜到底你們的政策細節內容到底是什麼還有評估量表相互轉換的時候這樣子的話會減少不同服務間重新評估的次數也沒有必要因為各種這麼多的量表而且評估出來的那個最後的結果也不太一樣\n還有人力空缺 我覺得禁書要提出解方沒有人力大家就沒有長照還有移工僱主 住宿型機構使用者要給予服務的公平對待還有希望你能夠建立長照制度跟盈利機構之間的合作模式我想部長不知道這幾項是不是可以在一個月後大概給我一些你們後來做的做法的報告好的 沒問題好 謝謝部長謝謝林委員 謝謝部長 次長\n","vtt":"WEBVTT\n\n00:06.722 --> 00:35.047\n主席有請那個呂次長好次長市長早委員長好市長因應我們的長照需求減輕家庭負擔我們在2017年就推動了長照10年的計畫那現在為了我們的實踐總統的建立台灣的國政願景呢事實上\n\n00:35.546 --> 00:50.819\n要優化長照2.0來啟動長照3.0你們3月份也開始去做這樣子的一個討論希望摒除掉長照2.0的一些比較不OK的狀態裡邊然後能夠去優化然後來提出長照3.0\n\n00:52.082 --> 01:13.901\n所以看起來不只是我覺得量的問題跟值得提升看你們報告看起來事實上是大家滿意度也非常高可是我們當然希望長照3.0可以更好的話那就想來問就是衛福部一直都沒有對社會好好說明就是說社會各界都是對長照3.0有無限美好的想像\n\n01:14.782 --> 01:36.455\n那可是當然也有更多的猜測至少明天團體是這樣就請問究竟什麼是長照3.0那是不是可以簡單說明我跟委員報告簡單三個重點第一個事實上就是因為賴先德中華自己本身也是醫生那邱部長他這邊也非常非常琢磨所以我們第一個重點事實上就是醫療與長照的結合\n\n01:38.676 --> 02:06.736\n那這裡面具體來說就兩個重點第一個就是PAC就是即興後期另外第二個部分事實上就是有跟大家一計畫的導入所以這第一個重點第二個是積極賦能我們希望我們的長輩他不僅僅只是這一個長照而已而且甚至如果盡可能的話他甚至還可以改善他的整個這一個照顧等級所以賦能不光復健是賦能的部分第三個事實上就是整個所謂的我們所謂安寧善終的概念我們希望我們每位長輩\n\n02:07.737 --> 02:24.203\n或者我們每位被照顧的一個長輩他都能夠有一個最好的一個照顧所以簡單來說這三個重點次長你這樣講的話就是因為從你的書面報告裡面列出了八大目標嘛所以我就換個角度來問像你剛剛提的\n\n02:27.385 --> 02:47.046\n這到底是不是你的政策亮點因為我覺得如果從8A目標裡面去看勉強如果講亮點的話就導入智慧照顧跟落實安寧善終之外可是你剛剛講大家醫這些那這是不是你長照3.0的政策亮點嗎或者你現在可不可以講說具體你們的政策亮點是什麼\n\n02:48.381 --> 03:11.250\n我也必須要跟委員報告啦因為現在目前就是我們現在目前整個的計畫都已經送到行政院那行政院現在目前我們要等待他的這個核定但是如果說我現在可以透露的話主要就是委員剛剛所說的就是剛剛說的大嘉義計畫裡面因為我們現在也會非常重要是希望就是說我們的照顧能夠盡可能的也能夠提供到居家\n\n03:11.990 --> 03:36.837\n所以我們到時候像部長他是就是大家一計劃裡面我們有關於那個有關居家照顧的這部分還有像是室長他一直都在推動有關HAH的這一個部分我們去年也已經推動了這一個在來急症照護在這個基礎上面我們會來來往就是整個這一個居家的這一個的這一個醫療照顧的部分來推動\n\n03:39.619 --> 03:45.508\n因為在有限的裁員底下勢必要集中資源來擴大服務對象避免重複的開銷\n\n03:48.581 --> 04:11.907\n同時也可以增加服務項目所以達到1加1等於2的效果這是市政的ABC那所以民間大也是期待就是說醫療跟社福接下來方向長照應該是說醫療跟社福是不是可以整合在社區裡邊那當然我們更希望擴大服務對象兒少老夫這樣是不是可以都納入所以我覺得長照是不是可以去整合到居家社區跟醫療社福\n\n04:13.686 --> 04:36.592\n甚至連續性照顧的服務來擴大服務對象增加服務項目所以我就要問市長這邊想問的是首先原本整合的事實上是我們的身障跟腸整合進去所以那個身障的服務那同時我們也看到這兩個服務但事實上是某些部分類似的項目可以互相替代可是\n\n04:37.185 --> 04:51.087\n像居家服務跟個住可是實務上卻有我們現在就最近是收到一些案子就是說像成古部全鎮也就俗稱玻璃娃娃的藏友們他本身通過了ICF的鑑定\n\n04:52.270 --> 05:15.578\n也就是它事實上是重度障礙的可是沒有辦法通過你們的CNS因為這個CNS評估說它是健康那就讓民眾無法理解所以我覺得本席是認為說衛福部是不是要先解決你們很多的評估CNSCDRICFADLIADL的各種評估相互競合的問題你怎麼做\n\n05:19.124 --> 05:43.549\n這幾個這麼多的不同的那你們這邊有這麼多的那你看評估又不一樣喔那就像我剛剛講的這個陳骨部全政一個評估說他健康一個評估說他重度腸臟那他到底可不可以用腸臟呢報告報告委員威強委員確實也點出一個重點現在目前就是說這個評估的量表非常多不過我也跟委員報告現在就是說就個案的本身而言他的病程其實在每個階段都會有他不同的這個變化\n\n05:45.745 --> 05:57.385\n就是他的整個這個他的病程的發展的階段其實事實上還是可是不會落差這麼的大因為一個評估事實上是重度產生一個事實上是\n\n05:58.275 --> 06:19.857\n健康我覺得這落差太大了但我們承認有時候病程不一樣可是他本身的狀態他本來就是玻璃瓦花那所以我覺得你們是不是要去討論一下這評估量表之間的落差度跟進合那另外就是針對於我們的身臟的日照跟長照日照整合\n\n06:20.397 --> 06:43.092\n去年我就提過了照顧人員資格的問題我們有跟你們就教就是衛福部那時候表示說照顧服務人員定義要放寬納入照顧服務員照保員跟生活服務員不去干涉各項職別的高低因為去年有發生過一些問題所以要去修正我們的長照服務人員訓練認證繼續教育跟登錄辦法請問一下進度如何\n\n06:47.214 --> 07:09.051\n報告委員我知道委員一直以來都對這個問題非常關心那我覺得確實這是一個痛點所以我們也根據委員的一個建議我們現在目前已經在預告我們現在目前已經進入到預告階段那收集各方意見之後我想我們就是委員的建議非常好我們要朝這個方向我們來推進因為這些人都待在機構裡面明明真的不太一樣他們的權益會受到損傷\n\n07:10.552 --> 07:22.290\n那另外就來問是2023年的話平均每位照顧服務員的照顧人數是平均10.8位個案合理的話事實上是5到7所以這已經超過了可是超過以外\n\n07:23.430 --> 07:45.841\n你的平均台北市苗栗縣雲林縣澎湖縣基隆市新竹市金門連江縣都高過平均數位所以就要想來問部長幾個問題第一個照顧產業的人事成本大概佔六成以上長照就是人力密集的產業當下人力顯然是不足的話政府怎麼去因應這個問題\n\n07:46.701 --> 08:08.331\n包委員我想我們現在目前在整個3.0裡面有三個主要的策略第一個其實主要事實上還是薪資跟這一個勞動條件的一個改善第二個其實最重要事實上沒錯舉世皆然整個照顧服務其實上是一個levelintensive是一個高度高度需要勞動力所以這個部分我們主要是希望未來能夠引進這個輔具就是說整個輔具的這個引進能夠來大量來減輕他的譬如說\n\n08:14.374 --> 08:39.826\n對沒錯譬如說現在機構裡面像有關於這個洗澡機這一個的使用第三個我跟委員報告我們未來會在整個這個造福園裡面我們事實上是會有分級就是說有高階有資深中階低階然後未來我們也會有一個整個跟這個部分公使彼此之間一個多元的一個交錯的一個策略來解決我們現在人力的問題\n\n08:40.706 --> 08:47.390\n人力事實上還有個錢的問題就居家服務的照顧服務員的薪資目前月薪是3萬2\n\n08:49.209 --> 09:11.819\n那時薪是200政府有調新的規劃嗎報告委員我們現在目前這個部分我也有薪資這個我們大家都非常關心那如果財政上如果可以允許我們當然會但是現在我也必須要報告委員我們現在目前其實居福的部分我想要舉一個最簡單的數據在2.0的時候其實當時是25433我們在去年已經突破10萬\n\n09:17.816 --> 09:42.466\n已經突破10萬了那這個人數增加表示就是說我也跟各位報告他在這一個2.0在1.0的時候平均薪資是25K到現在已經是4萬所以這個事實上薪資事實上是在調升當中那也也顯見就是說他事實上是一個居福事實上是一個未來有前景的一個產業是那我們這個部分意思是說現在目前就是沒還沒有規劃到這邊後邊要看財政的狀況是嗎\n\n09:43.325 --> 10:07.242\n我們會透過各項的一個整個這一個機制也會在也會跟部長部長其實也非常非常關心這個部分他也一直在強調其實要讓我們的這個長照做得好其實事實上整個薪資我們在財政允許的部分我們一定會來全力來推動好的那政府鼓勵我們的住宿型機構提供長照科系的學生\n\n10:07.762 --> 10:14.236\n有實習的機會來提高我們的留用率那請問取得照顧服務員資格的實習生實習過程當中\n\n10:16.226 --> 10:38.071\n得以占機構人力比嗎這件事有確定嗎我們已經確定了在本國的這部分我們已經確定了我們也認為這個事實上是應該推動的方向如果沒有得到兆福園資格的實習生占部分人力比目前的研議狀況如何包委員這個部分恐怕就我們現在暫時覺得可能是有疑慮\n\n10:40.111 --> 10:58.671\n那長遠來看的話衛福部將擴大住宿型機構的移工的聘僱人數可是蘭嶺移工的聘僱跟產業類的移工事實上是競爭人數成長有限那中階的技術人力跟在台的留學生人數也有限所以對此衛福部有什麼對策\n\n10:59.392 --> 11:23.272\n包委我們就是陳虎剛剛說的我們未來那個人力裡面除了我們的這個薪資提高之外來流入本勞之外另外我們也會從新南向國家就剛剛說的中介勞動力我們會來加強引進那從去年開始已經從這一個越南已經有引進那我們今年也會開始從印尼這邊那他只要在這邊服務滿6年那他就可以取得我們的永居\n\n11:23.792 --> 11:32.654\n那我就要再問一個居服員大多數是反對機構併僱移工的衛福部對此有開放移工的規劃嗎\n\n11:35.157 --> 11:54.676\n居府的部分現在目前還沒有居府的部分目前還沒有我們也知道本國我們的這個居府員他是現在這個疑慮但這部分我們當然我們只限住宿的部分而已因為住宿特別是夜間夜間人力的部分所以現在居府的這一塊沒有居府的部分我們是以目前我們現在就是本國\n\n11:57.350 --> 12:20.845\n但是我跟委員報告現在就是說但是機構的部分確實在夜間的部分這個我想本國的這一個居服員他可能有一些偏好的問題所以這個部分我們就是優先我們會從這個外籍的中階勞動力來補儲這個部分那再來問數數型機構量能不足沒有辦法滿足10萬人的需求\n\n12:21.706 --> 12:37.647\n所以政府持續對於公社興建跟公社協力的興建機構做補助去年中旬就有從事長照服務的盈利單位股票上市這是市場自然發生的趨勢之一可是一直以來\n\n12:38.327 --> 12:53.134\n礙於老福法的三不政策住宿型機構未能納入到廠商支付的對象包括健保在宅醫療支付項目都受到限制所以想問為何不面對到我們這種日漸多元的市場經營模式的話實在有必要調整\n\n12:54.574 --> 13:05.858\n以非營利為主的政策方向來建立適度的引入我們的營利機構服務量能的方法對此政府有沒有什麼樣的規劃其實我們在整個49層以下我們在在宅那個部分其實\n\n13:10.840 --> 13:37.328\n提升計畫裡面那邊我們事實上是有的這是第一我跟委員說明一下那至於您剛剛所說的就是未來有關於這個機構的部分我們會未來我覺得49床其實也是我們非常重要的一個未來3.0非常重要的一個省力軍因為它的加速也事實上夠多那我們未來要建構一個10分鐘照顧圈我覺得一定是這個49床以下這個機構一定要進來所以我們也會加強這部分的一個整個補助跟輔導\n\n13:38.268 --> 14:07.386\n好最後就請部長是不是可以針對我接下來這3.0的強烈建議希望政策方向請拜託跟人民說明清楚讓人民充分的去了解否則很多民軍團體也在猜到底你們的政策細節內容到底是什麼還有評估量表相互轉換的時候這樣子的話會減少不同服務間重新評估的次數也沒有必要因為各種這麼多的量表而且評估出來的那個最後的結果也不太一樣\n\n14:08.146 --> 14:34.557\n還有人力空缺我覺得禁書要提出解方沒有人力大家就沒有長照還有移工僱主住宿型機構使用者要給予服務的公平對待還有希望你能夠建立長照制度跟盈利機構之間的合作模式我想部長不知道這幾項是不是可以在一個月後大概給我一些你們後來做的做法的報告好的沒問題好謝謝部長謝謝林委員謝謝部長次長\n\n","segments":[{"start":6.722,"end":35.047,"text":"主席有請那個呂次長好 次長市長早 委員長好市長因應我們的長照需求減輕家庭負擔我們在2017年就推動了長照10年的計畫那現在為了我們的實踐總統的建立台灣的國政願景呢事實上"},{"start":35.546,"end":50.819,"text":"要優化長照2.0來啟動長照3.0你們3月份也開始去做這樣子的一個討論希望摒除掉長照2.0的一些比較不OK的狀態裡邊然後能夠去優化然後來提出長照3.0"},{"start":52.082,"end":73.901,"text":"所以看起來不只是我覺得量的問題跟值得提升看你們報告看起來事實上是大家滿意度也非常高可是我們當然希望長照3.0可以更好的話那就想來問就是衛福部一直都沒有對社會好好說明就是說社會各界都是對長照3.0有無限美好的想像"},{"start":74.782,"end":96.455,"text":"那可是當然也有更多的猜測至少明天團體是這樣就請問究竟什麼是長照3.0那是不是可以簡單說明我跟委員報告簡單三個重點第一個事實上就是因為賴先德中華自己本身也是醫生那邱部長他這邊也非常非常琢磨所以我們第一個重點事實上就是醫療與長照的結合"},{"start":98.676,"end":126.736,"text":"那這裡面具體來說就兩個重點第一個就是PAC就是即興後期另外第二個部分事實上就是有跟大家一計畫的導入所以這第一個重點第二個是積極賦能我們希望我們的長輩他不僅僅只是這一個長照而已而且甚至如果盡可能的話他甚至還可以改善他的整個這一個照顧等級所以賦能不光復健是賦能的部分第三個事實上就是整個所謂的我們所謂安寧善終的概念我們希望我們每位長輩"},{"start":127.737,"end":144.203,"text":"或者我們每位被照顧的一個長輩他都能夠有一個最好的一個照顧所以簡單來說這三個重點次長你這樣講的話就是因為從你的書面報告裡面列出了八大目標嘛所以我就換個角度來問像你剛剛提的"},{"start":147.385,"end":167.046,"text":"這到底是不是你的政策亮點 因為我覺得如果從8A目標裡面去看 勉強如果講亮點的話就導入智慧照顧跟落實安寧善終之外可是你剛剛講大家醫這些 那這是不是你長照3.0的政策亮點嗎或者你現在可不可以講說 具體你們的政策亮點是什麼"},{"start":168.381,"end":191.25,"text":"我也必須要跟委員報告啦因為現在目前就是我們現在目前整個的計畫都已經送到行政院那行政院現在目前我們要等待他的這個核定但是如果說我現在可以透露的話主要就是委員剛剛所說的就是剛剛說的大嘉義計畫裡面因為我們現在也會非常重要是希望就是說我們的照顧能夠盡可能的也能夠提供到居家"},{"start":191.99,"end":216.837,"text":"所以我們到時候像部長他是就是大家一計劃裡面我們有關於那個有關居家照顧的這部分還有像是室長他一直都在推動有關HAH的這一個部分我們去年也已經推動了這一個在來急症照護在這個基礎上面我們會來來往就是整個這一個居家的這一個的這一個醫療照顧的部分來推動"},{"start":219.619,"end":225.508,"text":"因為在有限的裁員底下勢必要集中資源來擴大服務對象避免重複的開銷"},{"start":228.581,"end":251.907,"text":"同時也可以增加服務項目所以達到1加1等於2的效果這是市政的ABC那所以民間大也是期待就是說醫療跟社福接下來方向長照應該是說醫療跟社福是不是可以整合在社區裡邊那當然我們更希望擴大服務對象兒少老夫這樣是不是可以都納入所以我覺得長照是不是可以去整合到居家社區跟醫療社福"},{"start":253.686,"end":276.592,"text":"甚至連續性照顧的服務來擴大服務對象增加服務項目所以我就要問市長這邊想問的是首先原本整合的事實上是我們的身障跟腸整合進去所以那個身障的服務那同時我們也看到這兩個服務但事實上是某些部分類似的項目可以互相替代可是"},{"start":277.185,"end":291.087,"text":"像居家服務跟個住可是實務上卻有我們現在就最近是收到一些案子就是說像成古部全鎮也就俗稱玻璃娃娃的藏友們他本身通過了ICF的鑑定"},{"start":292.27,"end":315.578,"text":"也就是它事實上是重度障礙的可是沒有辦法通過你們的CNS因為這個CNS評估說它是健康那就讓民眾無法理解所以我覺得本席是認為說衛福部是不是要先解決你們很多的評估CNS CDR ICF ADL IADL的各種評估相互競合的問題你怎麼做"},{"start":319.124,"end":343.549,"text":"這幾個這麼多的不同的那你們這邊有這麼多的那你看評估又不一樣喔那就像我剛剛講的這個陳骨部全政一個評估說他健康一個評估說他重度腸臟那他到底可不可以用腸臟呢報告 報告委員威強委員確實也點出一個重點現在目前就是說這個評估的量表非常多不過我也跟委員報告現在就是說就個案的本身而言他的病程其實在每個階段都會有他不同的這個變化"},{"start":345.745,"end":357.385,"text":"就是他的整個這個他的病程的發展的階段其實事實上還是可是不會落差這麼的大因為一個評估事實上是重度產生一個事實上是"},{"start":358.275,"end":379.857,"text":"健康我覺得這落差太大了但我們承認有時候病程不一樣可是他本身的狀態他本來就是玻璃瓦花那所以我覺得你們是不是要去討論一下這評估量表之間的落差度跟進合那另外就是針對於我們的身臟的日照跟長照日照整合"},{"start":380.397,"end":403.092,"text":"去年我就提過了照顧人員資格的問題我們有跟你們就教就是衛福部那時候表示說照顧服務人員定義要放寬納入照顧服務員 照保員跟生活服務員不去干涉各項職別的高低因為去年有發生過一些問題所以要去修正我們的長照服務人員訓練認證繼續教育跟登錄辦法請問一下進度如何"},{"start":407.214,"end":429.051,"text":"報告委員 我知道委員一直以來都對這個問題非常關心 那我覺得確實這是一個痛點所以我們也根據委員的一個建議 我們現在目前已經在預告我們現在目前已經進入到預告階段 那收集各方意見之後我想我們就是委員的建議非常好 我們要朝這個方向 我們來推進因為這些人都待在機構裡面 明明真的不太一樣 他們的權益會受到損傷"},{"start":430.552,"end":442.29,"text":"那另外就來問是2023年的話平均每位照顧服務員的照顧人數是平均10.8位個案合理的話事實上是5到7所以這已經超過了可是超過以外"},{"start":443.43,"end":465.841,"text":"你的平均台北市苗栗縣雲林縣澎湖縣基隆市新竹市金門連江縣都高過平均數位所以就要想來問部長幾個問題第一個照顧產業的人事成本大概佔六成以上長照就是人力密集的產業當下人力顯然是不足的話政府怎麼去因應這個問題"},{"start":466.701,"end":488.331,"text":"包委員我想我們現在目前在整個3.0裡面有三個主要的策略第一個其實主要事實上還是薪資跟這一個勞動條件的一個改善第二個其實最重要事實上沒錯舉世皆然整個照顧服務其實上是一個level intensive是一個高度高度需要勞動力所以這個部分我們主要是希望未來能夠引進這個輔具就是說整個輔具的這個引進能夠來大量來減輕他的譬如說"},{"start":494.374,"end":519.826,"text":"對 沒錯 譬如說現在機構裡面像有關於這個洗澡機這一個的使用第三個 我跟委員報告我們未來會在整個這個造福園裡面我們事實上是會有分級就是說有高階 有資深 中階 低階然後未來我們也會有一個整個跟這個部分公使彼此之間一個多元的一個交錯的一個策略來解決我們現在人力的問題"},{"start":520.706,"end":527.39,"text":"人力事實上還有個錢的問題就居家服務的照顧服務員的薪資目前月薪是3萬2"},{"start":529.209,"end":551.819,"text":"那時薪是200政府有調新的規劃嗎報告委員我們現在目前這個部分我也有薪資這個我們大家都非常關心那如果財政上如果可以允許我們當然會但是現在我也必須要報告委員我們現在目前其實居福的部分我想要舉一個最簡單的數據在2.0的時候其實當時是25433我們在去年已經突破10萬"},{"start":557.816,"end":582.466,"text":"已經突破10萬了那這個人數增加表示就是說我也跟各位報告他在這一個2.0在1.0的時候平均薪資是25K到現在已經是4萬所以這個事實上薪資事實上是在調升當中那也也顯見就是說他事實上是一個居福事實上是一個未來有前景的一個產業是那我們這個部分意思是說現在目前就是沒還沒有規劃到這邊後邊要看財政的狀況是嗎"},{"start":583.325,"end":607.242,"text":"我們會透過各項的一個整個這一個機制也會在也會跟部長部長其實也非常非常關心這個部分他也一直在強調其實要讓我們的這個長照做得好其實事實上整個薪資我們在財政允許的部分我們一定會來全力來推動好的那政府鼓勵我們的住宿型機構提供長照科系的學生"},{"start":607.762,"end":614.236,"text":"有實習的機會來提高我們的留用率那請問取得照顧服務員資格的實習生實習過程當中"},{"start":616.226,"end":638.071,"text":"得以占機構人力比嗎 這件事有確定嗎我們已經確定了 在本國的這部分我們已經確定了我們也認為這個事實上是應該推動的方向如果沒有得到兆福園資格的實習生占部分人力比目前的研議狀況如何包委員這個部分恐怕就我們現在暫時覺得可能是有疑慮"},{"start":640.111,"end":658.671,"text":"那長遠來看的話衛福部將擴大住宿型機構的移工的聘僱人數可是蘭嶺移工的聘僱跟產業類的移工事實上是競爭人數成長有限那中階的技術人力跟在台的留學生人數也有限所以對此衛福部有什麼對策"},{"start":659.392,"end":683.272,"text":"包委我們就是陳虎剛剛說的我們未來那個人力裡面除了我們的這個薪資提高之外來流入本勞之外另外我們也會從新南向國家就剛剛說的中介勞動力我們會來加強引進那從去年開始已經從這一個越南已經有引進那我們今年也會開始從印尼這邊那他只要在這邊服務滿6年那他就可以取得我們的永居"},{"start":683.792,"end":692.654,"text":"那我就要再問一個居服員大多數是反對機構併僱移工的衛福部對此有開放移工的規劃嗎"},{"start":695.157,"end":714.676,"text":"居府的部分現在目前還沒有居府的部分目前還沒有我們也知道本國我們的這個居府員他是現在這個疑慮但這部分我們當然我們只限住宿的部分而已因為住宿特別是夜間夜間人力的部分所以現在居府的這一塊沒有居府的部分我們是以目前我們現在就是本國"},{"start":717.35,"end":740.845,"text":"但是我跟委員報告 現在就是說 但是機構的部分確實在夜間的部分這個我想本國的這一個居服員他可能有一些偏好的問題所以這個部分我們就是優先我們會從這個外籍的中階勞動力來補儲這個部分那再來問 數數型機構量能不足沒有辦法滿足10萬人的需求"},{"start":741.706,"end":757.647,"text":"所以政府持續對於公社興建跟公社協力的興建機構做補助去年中旬就有從事長照服務的盈利單位股票上市這是市場自然發生的趨勢之一可是一直以來"},{"start":758.327,"end":773.134,"text":"礙於老福法的三不政策 住宿型機構未能納入到廠商支付的對象 包括健保 在宅醫療支付項目都受到限制所以想問 為何不面對到我們這種日漸多元的市場經營模式的話 實在有必要調整"},{"start":774.574,"end":785.858,"text":"以非營利為主的政策方向來建立適度的引入我們的營利機構服務量能的方法對此政府有沒有什麼樣的規劃其實我們在整個49層以下我們在在宅那個部分其實"},{"start":790.84,"end":817.328,"text":"提升計畫裡面 那邊我們事實上是有的這是第一 我跟委員說明一下那至於您剛剛所說的就是未來有關於這個機構的部分我們會未來 我覺得49床其實也是我們非常重要的一個未來3.0非常重要的一個省力軍因為它的加速也事實上夠多那我們未來要建構一個10分鐘照顧圈我覺得一定是這個49床以下這個機構一定要進來所以我們也會加強這部分的一個整個補助跟輔導"},{"start":818.268,"end":847.386,"text":"好最後就請部長是不是可以針對我接下來這3.0的強烈建議希望政策方向請拜託跟人民說明清楚讓人民充分的去了解否則很多民軍團體也在猜到底你們的政策細節內容到底是什麼還有評估量表相互轉換的時候這樣子的話會減少不同服務間重新評估的次數也沒有必要因為各種這麼多的量表而且評估出來的那個最後的結果也不太一樣"},{"start":848.146,"end":874.557,"text":"還有人力空缺 我覺得禁書要提出解方沒有人力大家就沒有長照還有移工僱主 住宿型機構使用者要給予服務的公平對待還有希望你能夠建立長照制度跟盈利機構之間的合作模式我想部長不知道這幾項是不是可以在一個月後大概給我一些你們後來做的做法的報告好的 沒問題好 謝謝部長謝謝林委員 謝謝部長 次長"}]}}},"gazette":{"lineno":222,"blocks":[["林委員月琴：（9時26分）主席，有請呂次長。"],["主席：好，請次長。"],["林委員月琴：次長早。"],["呂次長建德：委員早安。"],["林委員月琴：為因應長照需求並減輕家庭負擔，政府自2017年起就推動了長照十年計畫，並且為了實踐總統「健康台灣」之國政願景，要優化長照2.0並啟動長照3.0，行政院裁示自2026年起推動長照十年計畫3.0，衛福部從今年3月份也開始提前啟動長照3.0規劃的討論，希望摒除長照2.0一些比較不OK的狀態，能夠予以優化之後提出長照3.0，看起來長照2.0不只是量的增加，也是質的提升，從你們的報告看起來，事實上大家的滿意度也非常高嘛？"],["呂次長建德：是。"],["林委員月琴：我們當然也希望長照3.0可以更好，但是衛福部一直都沒有對社會好好地說明，社會各界都對長照3.0有無限美好的想像，可是當然也有更多的揣測，至少民間團體是這樣，請問究竟什麼是長照3.0，是不是可以簡單說明？"],["呂次長建德：好。我跟委員報告，簡單三個重點：第一個，因為賴清德總統他本身也是醫生，我們邱部長這邊也非常非常著墨，所以我們第一個重點就是醫療與長照的結合，這裡面具體來說就兩個重點，第一個就是PAC，就是急性後期整合照護計畫；另外第二個部分就是有關大家醫計畫的導入，這是第一個重點。第二個是積極復能，我們希望我們的長輩不僅是接受長照而已，甚至如果可能的話還可以改善他的照顧等級，所以不光是復健，而是希望能夠復能。第三個就是我們所謂安寧善終的概念，我們希望每位被照顧的長輩都能夠獲得最好的照顧，所以簡單來說就是這三個重點。"],["林委員月琴：次長，你的書面報告裡面列出了八大目標嘛？"],["呂次長建德：對。"],["林委員月琴：所以我換個角度來問，像你剛剛提的這三個，到底是不是你的政策亮點？因為從八大目標裡面去看，勉強如果要講亮點的話，除了「導入智慧照顧」、「落實安寧善終」之外，就是你剛才講的大家醫這些，這是你的長照3.0的政策亮點嗎？或者你現在可不可以說明，你們具體的政策亮點是什麼？"],["呂次長建德：好，OK。我也必須要跟委員報告，因為現在我們整個計畫都已經送到行政院，目前我們在等待行政院的核定。但是如果我現在可以透露的話，主要就是剛剛說的大家醫計畫裡面有一個非常重要的是，希望我們的照顧也能夠盡可能的提供到居家。所以到時候，像部長提到大家醫計畫裡面有關於居家照顧的部分，還有像石崇良署長一直都在推動有關HAH的這個部分；我們去年也已經推動了在宅急症照護，在這個基礎上面，我們會往整個居家醫療照顧的部分來推動。"],["林委員月琴：好。在國家財源有限的情況下，勢必要集中資源來擴大服務對象，避免重複開支，同時也能增加服務項目，達到1加1大於2的效果，這是施政的ABC。所以民間大家也期待，接下來長照的方向是不是可以將醫療跟社福整合在社區裡面……"],["呂次長建德：沒錯、沒錯、是。"],["林委員月琴：當然我們更希望擴大服務對象，兒少老福障是不是可以都納入，所以我覺得長照是不是可以去整合居家、社區、醫療、社福，甚至是連續性照顧服務，擴大服務對象、增加服務項目，所以我就要問次長，首先、原本是把我們的身障整合進去。"],["呂次長建德：對，沒錯。"],["林委員月琴：所以那個身障者服務……同時我們也看到這兩個服務大概是某些部分類似的項目可以互相替代，像居家服務跟個助，可是實務上，最近我們有收到一些案子，像成骨不全症，也就是俗稱玻璃娃娃的障友們，他本身通過了ICF的鑑定，也就是他事實上是重度障礙，可是沒有辦法通過你們的CMS，因為CMS評估他是健康，這就讓民眾無法理解啊！所以本席認為衛福部是不是要先解決你們很多的評估，像CMS、CDR、ICF、ADL、IADL等，各種評估相互競合的問題你要怎麼做？你們這邊有這麼多不同的評估；你看，評估結果又不一樣喔，就像我剛剛講的成骨不全症，一個評估說他健康，一個評估說他是重度障礙，那他到底可不可以用長照？"],["呂次長建德：報告委員，我想委員確實也點出一個重點，目前評估的量表非常多，不過我也跟委員報告，就個案本身而言，他的病程其實在每個階段都會有不同的變化，就是他整個病程的發展階段，事實上還是……"],["林委員月琴：可是不會落差這麼大，因為一個評估說是重度障礙，一個說是健康，我覺得這個落差太大了。當然我們承認有時候病程不一樣，可是他本身的狀態，他本來就是玻璃娃娃，所以我覺得你們是不是要去討論一下評估量表之間的落差度跟競合？"],["呂次長建德：OK、好。"],["林委員月琴：另外，針對我們身障日照與長照日照的整合，去年我就有提過照顧人員資格的問題，我們有跟你們就教，衛福部那時候表示照顧服務人員定義要放寬，納入照顧服務員、教保員跟生活服務員，不去干涉各項職別的高低，因為去年有發生過一些問題，所以要去修正我們的長照服務人員訓練認證繼續教育及登錄辦法，請問進度如何？"],["呂次長建德：報告委員，我知道委員一直以來都對這個問題非常關心，我覺得這確實是一個痛點，所以我們也根據委員的建議，目前我們已經進入預告階段，蒐集各方意見之後，我想委員的建議非常好，我們就朝這個方向來推進。"],["林委員月琴：因為這些人都待在機構裡面，可是名稱不太一樣，他們的權益會受到損傷。"],["呂次長建德：沒錯。"],["林委員月琴：另外要問的是，2023年，平均每位照顧服務員的照顧人數是10.8位個案，合理的人數是5到7位，所以這已經超過了，可是超過以外，包括臺北市、苗栗縣、雲林縣、澎湖縣、基隆市、新竹市、金門縣、連江縣都高於平均數，所以就想問次長幾個問題，第一個，照顧產業的人事成本大概占六成以上。"],["呂次長建德：對，沒錯。"],["林委員月琴：長照就是人力密集的產業，當下人力顯然是不足的，政府怎麼因應這個問題？"],["呂次長建德：報告委員，我想我們目前在整個3.0裡面有三個主要策略，第一個，其實主要還是薪資跟勞動條件的改善；第二個，最重要的是，沒錯，舉世皆然，整個照顧服務事實上是一個labor intensive，是高度需要勞動力的，所以這個部分我們主要是希望未來能夠引進輔具，就是說整個輔具的引進來減輕他的……"],["林委員月琴：減輕人力負擔嗎？"],["呂次長建德：對，沒錯，比如說在機構裡面像有關於洗澡機的使用。第三個，跟委員報告，未來我們在整個照服員裡面會有分級，就是說有資深、中階、低階，且跟部分工時彼此之間會有一個多元交錯的策略，以解決我們現在人力的問題。"],["林委員月琴：除了人力，事實上還有一個錢的問題，就是居家照顧服務員的薪資，目前他們的月薪是3萬2,000元，時薪是200元，政府有調薪的規劃嗎？"],["呂次長建德：報告委員，目前這個部分，我想薪資我們大家都非常關心，如果財政上允許，我們當然會……但是現在我也必須報告委員，目前關於居服的部分，舉一個最簡單的數據，在2.0的時候，其實當時是2萬5,433，我們在去年已經突破10萬，已經突破10萬人，這個人數增加表示的是，我也跟各位報告，在1.0的時候，平均薪資是25K，到現在已經是4萬，所以薪資事實上是在調升當中，顯見居服是未來有前景的一個產業，我們這個部分……"],["林委員月琴：意思是說目前還沒有規劃到這邊，後面要看財政的狀況，是嗎？"],["呂次長建德：我們會透過各項機制，也會跟部長……部長其實也非常非常關心這個部分，他也一直強調要讓我們的長照做得好，事實上整個薪資在財政允許的部分，我們一定會全力來推動。"],["林委員月琴：好，再麻煩去做考量。"],["呂次長建德：好的。"],["林委員月琴：政府鼓勵我們的住宿型機構提供長照科系學生有實習的機會來提高我們的留用率，請問取得照顧服務員資格的實習生實習過程當中得以占機構人力比嗎？這件事有確定嗎？"],["呂次長建德：這個我們已經確定了，在本國的這部分，我們已經確定了，我們也認為這個事實上是應該推動的方向。"],["林委員月琴：如果沒有得到照服員資格的實習生，占部分人力比目前的研議狀況如何？"],["呂次長建德：報告委員，這個部分我們現在暫時覺得可能是有疑慮。"],["林委員月琴：長遠來看，衛福部將擴大住宿型機構移工的聘僱人數。"],["呂次長建德：是，沒錯、沒錯。"],["林委員月琴：可是藍領移工的聘僱跟產業類的移工事實上是競爭的，人數成長有限，中階技術人力跟在臺留學生人數也有限，所以對此衛福部有什麼對策？"],["呂次長建德：報告委員，誠如我剛剛說的，我們未來的人力裡面，除了我們的薪資提高來留住本勞之外，另外我們也會從新南向國家，就是剛剛說的中階勞動力，我們會加強引進，從去年開始已經有從越南引進，我們今年也會開始從印尼這邊引進，他只要在這邊服務滿6年就可以取得我們的永居、永久居留權。"],["林委員月琴：我們就要再問一個問題，居服員大多數是反對機構聘僱移工，衛福部對此有開放移工的規劃嗎？"],["呂次長建德：居服的部分目前還沒有，我們也知道本國居服員現在有這個疑慮，這個部分我們只限住宿的部分而已，因為住宿特別是夜間人力的部分……"],["林委員月琴：所以現在居服的這一塊……"],["呂次長建德：沒有，居服的部分我們現在就是本國的，但是我跟委員報告，機構的部分，確實在夜間的部分，我想本國的居服員可能有一些偏好的問題，所以我們會優先從外籍中階勞動力來補足這個部分。"],["林委員月琴：再問，住宿型機構量能不足，沒有辦法滿足10萬人的需求，所以政府持續對於公設興建跟公私協力興建機構作補助，去年中旬就有從事長照服務的營利單位股票上市了。"],["呂次長建德：對。"],["林委員月琴：這是市場自然發生的趨勢之一，可是一直以來，礙於老福法的三不政策，住宿型機構未能納入長照支付對象，包括健保在宅醫療項目支付都受到限制。所以想問的是，衛福部面對日漸多元的市場經營模式，實在有必要調整以非營利為主的政策方向，建立適度引入營利機構服務量能的方法，對此政府有沒有什麼樣的規劃？"],["呂次長建德：報告委員，其實我們在整個49床以下，我們在在宅那個部分，其實在品質提升計畫裡面我們事實上是有的，這是第一個我跟委員說明一下，至於您剛剛所說的，就是未來有關於機構的部分，我覺得49床其實也是未來3.0非常重要的一個生力軍，因為它的家數也夠多，我們未來要建構一個10分鐘照顧圈，我覺得49床以下這個機構一定要進來，所以我們也會加強這部分整個補助跟輔導。"],["林委員月琴：好。最後，次長，接下來是我對3.0的強烈建議，希望政策方向能跟人民說明清楚，讓人民充分了解，否則很多民間團體也在猜你們的政策細緻內容到底是什麼。還有評估量表相互轉換，這樣會減少不同服務間重新評估的次數，也沒有必要，因為各種量表這麼多，而且評估出來最後的結果也不太一樣。還有人力空缺的部分，我覺得要儘速提出解方，沒有人力大概就沒有長照。還有移工雇主、住宿型機構使用者，要給予服務的公平對待，希望你們能夠建立長照制度跟營利機構之間的合作模式。部長，不知道這幾項是不是可以在一個月後給我你們後來作法的報告？"],["邱部長泰源：沒問題，好，謝謝委員。"],["呂次長建德：感謝委員。"],["主席：謝謝林委員，謝謝部長、次長。","接續我們請陳菁徽委員質詢。"]],"agenda":{"page_end":256,"meet_id":"委員會-11-3-26-10","speakers":["蘇清泉","陳昭姿","林月琴","陳菁徽","王育敏","邱鎮軍","林淑芬","涂權吉","黃秀芳","王正旭","陳瑩","廖偉翔","陳培瑜","李坤城","徐富癸","楊瓊瓔","楊曜","劉書彬","劉建國","黃國昌","顏寬恒","張嘉郡","伍麗華Saidhai‧Tahovecahe","翁曉玲"],"page_start":163,"meetingDate":["2025-05-08"],"gazette_id":"1144701","agenda_lcidc_ids":["1144701_00005"],"meet_name":"立法院第11屆第3會期社會福利及衛生環境委員會第10次全體委員會議紀錄","content":"一、邀請衛生福利部部長就「長照2.0執行情形檢討及3.0未來規劃」進行專題報告，並備質詢；\n二、邀請衛生福利部部長就「澳洲進口豬腳驗出含萊克多巴胺，如何加強肉品食安查驗，讓民眾\n放心」進行專題報告，並備質詢","agenda_id":"1144701_00004"}}}